Cervical cancer doesn’t discriminate, so why does the smear test?

Here’s a piece of confusing medical doctrine: in England, smear tests are offered to women from the age of 25. In Scotland, it’s 20. A couple of months ago, I checked myself in for a smear test, aged 23. The receptionist was easy to convince: ‘In Scotland,’ I said, ‘the age limit is lower. I’d like to have a test done.’ She understood, and booked me in.

But when it came to the appointment, there was no convincing the nurse. I asked why there were different age limits for different parts of the UK. She had no answer. Do the women of Scotland have an increased susceptibility to cervical cancer? No, she didn’t think so. So why then? No answer. At this point, she got a little exasperated with my questions, and tried to palm me off with a chlamydia test. I left in a huff.

Age limits on tests are understandable. But given that some parts of the UK seem to think I’m at risk, and others think I’m not, I’d have thought there would be some leeway. It seems not. Friends who have reached 25 tell me they are now bombarded with letters reminding them it’s time for their test.

I wasn’t surprised to read the sad story about 19-year-old Sophie Jones, who died last week of cervical cancer. She too had been refused a smear test, because she was ‘too young to get the disease’. Her family has launched a petition to prompt parliamentary debate into lowering the age limit for cervical screening. Lowering the age limit may not be medically sound – perhaps 25 is the correct age, but it’s concerning that no one seems able to explain what’s going on with the testing ranges. Either women are at risk at 20, or they are at risk at 25. Geography shouldn’t play a part in it. It’s time for a bit more clarity on the matter; and if a parliamentary debate will catalyse that, then that’s what we should indeed push for.

These sort of decisions are INVARIBLY taken based on statistical data. Disease rates, false positives and cost-benefit analyses will provide the reason for this policy.

If you are writing an article without mentioning this data then you are trying to start a discussion based on fundamental ignorance. And if you expect to join a debate without (as I suspect) any appreciation of the mathematics involved then you are contributing to the dumbing down of public life…

Liz

Why do asthmatics have to pay for inhalers until they are over 65?

D Whiggery

The NHS rations all care, at all levels, at all times. That means they’re obliged to discriminate in some way or other.